What Is the Difference Between Angiogram and Angioplasty?

Angiogram and angioplasty are two procedures that are used to treat or assess issues with blood vessels.

Angiogram and angioplasty are two procedures used to assess or treat issues with your blood vessels. Learn more about how they’re similar and where they differ, and why your doctor might recommend one or both. 

These procedures can work separately or together, and they are an important part of diagnostic testing and treatment for certain conditions.

Angiogram

An angiogram, also called an arteriogram or angiography, is a diagnostic procedure that creates pictures of your blood vessels. It takes a series of x-rays using an iodine dye — called contrast — that helps to reveal blood flow through vessels and any blockages they may have. In this minimally invasive procedure, a doctor inserts a catheter into a main artery, usually the femoral artery in your leg, so they can inject the dye. 

There are several types of angiogram procedures: 

• Coronary angiogram
• Aortic angiogram
• Pulmonary angiogram
• Cerebral angiogram
• Peripheral angiogram
• Renal angiogram 

You might also have a CT angiogram (CTA) or an MR angiogram (MRA), which are non-invasive imaging procedures that may or may not use contrast dye. The CT scan uses radiation, while the MR scan doesn't. 

Angioplasty

An angioplasty is a procedure that opens or unblocks an affected blood vessel to improve blood flow. This less-invasive procedure is also known as percutaneous transluminal angioplasty (PTA) due to the techniques used. 

In angioplasty, doctors will insert a catheter into your main artery and guide it to the blockage. This catheter has a small balloon at the tip that inflates and compresses the blockage, opening your blood vessel and improving blood flow. Sometimes, doctors insert a wire-mesh stent at the same time to keep the artery from collapsing.

There are several types of angioplasty depending on the location:

• Coronary angioplasty
• Cerebral angioplasty
• Renal artery angioplasty
• PTA of the femoral artery
• Balloon pulmonary angioplasty
• Carotid artery angioplasty

You might also receive laser angioplasty, in which doctors remove the blockage using laser radiation.

For your doctor to recommend an angiogram or angioplasty procedure, you would need to show certain health symptoms. These procedures are useful for a variety of medical conditions, typically those involving some type of blood flow restriction.

Here are some of the symptoms that may lead to each procedure:

Angiogram

• Chest pain
• Unexplained pain in jaw, neck, or arm
• Shortness of breath
• Severe headache
• Severe dizziness
• Double vision
• Have had a stroke or heart attack
• Have failed stress tests
• Have a possible blood clot or blockage
• Have a possible brain tumor

Angioplasty

• Regular chest pain 
• Regular shortness of breath
• Have blockage of more than 50% in a main artery
• Have blockage of more than 70% in a branching blood vessel
• Have coronary artery disease, carotid artery disease, peripheral artery disease, or atherosclerosis

As with any medical procedure, having an angiogram or angioplasty poses potential side effects or risks. Make sure to weigh the risks and benefits when speaking with your doctor about your health.

Angiogram

Both angiogram and angioplasty have the following potential side effects:

• Soreness
• Bruising
• Blood leakage at incision site
• Nausea or itching from the iodine dye

Potential complications for both procedures include:

• Catheter may get caught on or damage a blood vessel
• Severe allergic reaction to the iodine dye
• Heart attack or stroke
• Kidney damage from the dye
• Infection at wound site or inside blood vessel

Angioplasty

Angioplasty can have all the same possible side effects as angiogram. Additional potential complications for angioplasty include:

• Blood clot near or inside the stent 
• Restenosis, or re-narrowing of your arteries 

In some ways, the procedures for angiogram and angioplasty are similar. But because they work to solve different issues with your health, there are differences, too. 

Angiogram 

When you arrive for your procedure, you will receive sedation to help you relax, along with local anesthesia to numb the incision site. The doctor will make a small incision on the outer groin region to access your femoral artery. This artery is preferred because it is easily accessible and connects to all other arteries in the body.

The doctor inserts a thin catheter made of medical-grade tubing into your artery and threads it to the area needing examination. This area might be your heart, your brain, an arm, a leg, or even your kidneys. 

Next, the doctor injects iodine dye into the tubing so it emerges in the blood vessels they want to examine. Using an x-ray machine, the doctor takes a series of images showing your blood flow, heart function, blood pressure, and blood oxygen levels. They remove the catheter once the procedure is complete.

Each angiogram varies in duration, depending on location and what blockages or abnormalities the doctor may discover. In general, angiograms can last as little as 15 minutes to as much as 2 hours or longer. An angiogram is usually an outpatient procedure, where you go home the same day.

 Angioplasty

For an angioplasty, your procedure begins the same as an angiogram, where you are sedated and receive local anesthesia. The vascular surgeon again makes an incision and inserts a catheter tube into your femoral artery, threading it to the site of a blockage or narrowed artery. This catheter, though, has a small balloon at its tip.

Next, the surgeon inflates the balloon, which compresses the blockage against the artery wall. After deflating the balloon, the doctor injects iodine dye to check that your blood flow has improved. Once satisfied with the improvement, the doctor removes the balloon and catheter from your artery. 

Sometimes, the surgeon may insert a wire-mesh stent at the same time they inflate the balloon. They may add this step if they believe your artery is at risk of narrowing again. At the end of your procedure, they remove the balloon and catheter but leave the stent inside your artery. 

Depending on the type of angioplasty, it can last anywhere from 30 minutes to 3 hours or longer. With an angioplasty, it's common for you to stay overnight in the hospital so nurses can monitor your health and make sure the procedure was successful.

Recovery will begin right after both procedures, though with an angioplasty, you’ll likely stay in the hospital a bit longer.

Angiogram

After an angiogram, you may feel soreness at the incision site for one to two days. You may also have a bruise that lasts for one to two weeks. Your doctor will recommend that you avoid strenuous activity for at least a week and limit yourself to light activity for the first few days. 

Angioplasty

After an angioplasty, you will be discharged from the hospital 12 to 24 hours after your procedure, as long as you are responding well to the treatment. You may experience some normal soreness and bruising. Your doctor will recommend that you avoid strenuous activity for about a week. 

Recovery times vary from person to person. If you experience any serious side effects or complications, contact your doctor or call 9-1-1.